If it feels like everyone is talking about Paul Kalanithi’s book, When Breath Becomes Air, it’s because they are. In fact, there are several recent books and articles about the hot topic of death as this New York Magazine article points out. It is interesting that books about mortality - including Paul’s book, Michael Kinsley's Old Age, and Atul Gawande’s Being Mortal - made it to the New York Times’ bestseller list. We have a particular interest in these topics after our sister’s death from cancer, but, surprisingly, it looks like we are not alone even among death-phobic Americans. And here we almost named this website (sarcastically) “another f***ing blog about death.” We are so relieved. We don’t want to be the ones known as “the weird sisters that always talk about death.” #theyarealwayssad #alwaystalkingaboutdeath
Maybe a culture change is happening and Americans are more ready to face difficult topics, such as end of life, death, and grief. As the article notes, 90% of Americans in the Conversations Project survey felt that end of life discussions are important... yet just 27% of them went through with it. We completely agree that these are important discussions and hope that some are even happening ahead of time, to prevent undue stress when someone is dying. But if we’re not ready to truly tackle these issues, at least we are reading about them. We get that reading about death for leisure seems odd. Why would we be drawn to dark subject matters to fill our precious “down time?” We aren’t suggesting that you focus on these sad themes while on your beach vacation, but signs pointing to a shift away from a “death-avoidant culture” and towards an increased focus on end of life care are positive and we encourage it.
When our sister was dying, we found it incredibly difficult to have the necessary conversations and did not find much guidance regarding how best to handle it. Even doctors have a hard time giving their patients a straightforward prognosis and helping them prepare for death. Atul Gawande has brought to light the areas that are lacking as we approach death. Although Being Mortal is focused on aging and senior living, many of his ideas resonated with us, especially his call for medical professionals to focus on well-being, figure out what the patient values and how they want to live, nurture their independence, and not just fight and cure disease.
After our sister learned that there was no further treatment available to fight her cancer, we discovered that many people could not wrap their minds around a young person’s mortality. People continued to tell her and us that she was so strong, that they knew she could beat it. Paul Kalanithi’s When Breath Becomes Air provides an account of a young person coming to terms with death. You can understand his confusion - “what tense am I living in now?” - and his reaction to people making plans at a college reunion to see each other at the next one - “it seemed rude to respond with ‘Well… probably not.’” Like our sister, he was a doctor and a patient. His doctor gave him one of the greatest gifts we can imagine for someone like Paul and like our sister - she told him she was happy to have his input but also happy to just be the doctor. As Paul explained: “While being trained as a physician and scientist had helped me process the data and accept the limits of what that data could reveal about my prognosis, it didn’t help me as a patient…. Like my own patients, I had to face my mortality and try to understand what made my life worth living.”
When our sister died, we were shocked by how many people were at a loss for what to say or how to help us. This seems especially true for us young adults who may not have much experience with death and grief or have not really had a reason to stop and examine mortality. Perhaps at our young age, we feel invincible or feel that we are far away from dying. But as Paul’s wife Lucy wrote in the epilogue to his book: “[Paul] wanted to help people understand death and face their mortality. Dying in one’s fourth decade is unusual now, but dying is not.” The point of being more comfortable with death and mortality is to accept the inevitable in hopes of living a better life now. We also felt more sensitive to these subjects after caring for our sister and being present for her death. After our experience, it was jarring to witness conversations where people joked about terminal illness or death - friends in their 30s and 40s being dramatic about their minor ailments. We too frequently take for granted that others around us may be grieving. We also take for granted how valuable it is to LIVE life and to feel good.
For us, reading these books is a little like reliving the tragedy that we just experienced. We can only read them in small doses, but we are so impressed that these authors were able to draw attention to tragic yet important topics in such beautiful ways. We will all experience death and grief in our lives - and also perhaps caring for someone at the end of their life. You can face it head on, figure out how to deal with it, and some day it will change you and teach you more than you could ever imagine. Paul and Lucy Kalanithi opened up and shared genuine and brilliant thoughts on the meaning of life and death and in return, we are all benefiting. Paul's most powerful and breathtaking advice on life's meaning is directed at his infant daughter:
“When you come to one of the many moments in life where you must give an account of yourself, provide a ledger of what you have been, and done, and meant to the world, do not, I pray, discount that you filled a dying man’s days with a sated joy, a joy unknown to me in all my prior years, a joy that does not hunger for more and more but rests, satisfied. In this time, right now, that is an enormous thing.”